Organization
A. LILIKO'I PHARMACY
Active
Other names
Lily Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KAYCEE LYNN SUTTER (OWNER)
(808) 312-8738
Entity
Organization
Contact information
Practice address
2232 UNIVERSITY SQUARE MALL, TAMPA, FL 33612
(808) 312-8738
Mailing address
2232 UNIVERSITY SQUARE MALL, TAMPA, FL 33612
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
PH30612
FL
3336C0003X
Community/Retail Pharmacy
PH30612
FL
3336S0011X
Specialty Pharmacy
Primary
PH30612
FL
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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